,good evening and thank you for watching PBS Fort Wayne and I think you're going to be glad you did because we're just going to give you a whole lot of information tonight about health insurance and be talking about a lot of the changes that are coming out for twenty twenty five for Medicare and as usual every year Greg MacDonald comes and visits a couple of times to tell us about Medicare changes and answer questions about health insurance.

Now keep in mind this is really your show so if you have questions just give us a call down here at the bottom of the screen you'll see the phone number throughout the show and it's out (969) 27 twenty if you're not in the immediate area, just put an 866- in front of that and it'll be toll free for you.

>> I'm Candy Thompson, the host of the show but this is our real star of the show, Greg MacDonald.

>> Hi Sandy .

And I think probably by now a lot of people know you didn't we calculate you've been coming about ten years has been good ten years now.

>> Yeah.

At least twice a year in the U.S..

Yes.

This year it seems like it's even more relevant because according to information you shared with us last week when you were on and information that you have sent me beforehand that I've read it's a big year.

There are more changes.

It's more complicated than it's been for a while.

Is that correct?

That is very true because of changes that they have in the prescription drug plan.

>> Yeah, there's a lot of things going on there that really necessitates everyone who has a Medicare plan to check.

>> Are there drugs still covered ?

How are they being covered ?

>> Yeah, what's the premium your plan this year because almost all of them have changed and some of them gone up considerably.

Oh yeah.

We had a plan that was nine about nine dollars and some change last or twenty four it's going to be forty some dollars.

>> That's a big change.

That's a big change.

So yeah you're going to have to check check your plan, check what drugs are on it, check what your co-pays are.

>> This is the time to do it and this is one of the reasons that Greg comes this time of the year so that you're prepared and you make the changes that you want to or need to and then doesn't end up being January and all of a sudden you get bills that are higher and big surprise what happened?

>> I didn't know that.

Well, we're going to answer your questions and let you know about it.

According to research that I read, about 70 percent of Americans take at least one medication if not more.

>> Yeah.

So really I'm talking to 70 percent of you out there that may be affected by some of these things.

How about the all right.

>> Tell me again the intermittency the inflation inflation reduction I was trying to remember.

Yeah.

Inflation Reduction Act that is really going to be influencing a lot of what happens for you.

>> Can you explain what that is, Greg?

Oh, just real quickly it it changed how the drug plans function.

Yeah.

For twenty twenty five it capped the most that anyone can spend for drugs at two thousand dollars which is a good thing as opposed to the eight thousand eight thousand that was last year.

>> A big difference.

Big difference.

So for people who take a lot of drugs or expensive drugs it's really going to be a plus.

>> But the downside because anytime you do something one way you have a downside on the other it's going to increase costs for those who don't take as many drugs and it's going to restrict some of the formularies and it increases premiums on on the drug plan.

>> So it's a it's a mixed bag.

But for those who take a lot of prescriptions it's you it's really a good deal.

>> Well, according to what I've read and what I've seen a lot of the really popular drugs right now are some of them that are five hundred dollars or more a month.

>> Let's take Eliquis OK. OK because that's a common drug, right.

And Eliquis depending upon where you get it is five to six hundred dollars retail per month.

>> Wow.

And so if you're taking that it doesn't take long to get that to that two thousand dollar Sure level and so those are some of the things that's really going to help those who are taking those types of drugs.

>> Now let me make sure that I understand it correctly given our conversation last so you're the change of what you have to pay is two thousand dollars as opposed to a that's the maximum you have to pay.

>> Yeah, that's right.

Actually you might actually hit that two thousand dollar limit without paying two thousand dollars because that calculation is a combination of what you pay and what the insurance company OK to get there.

>> OK you know if I guess there we're talking about people that take fewer medications or maybe Tier one or generics or less.

Yes yes.

OK we have a phone call here and I'm so glad we do already.

This is from Janet.

Janet, thank you so much for watching us here on LIFE Ahead.

Here's what she wants to know Greg.

What if I select a plan but I change my mind?

Is there a window that I can make changes?

The answer is yes.

All right.

Depending on what the plan is so it never can be just really smooth.

Right.

So if you are selecting a Medicare Advantage plan, for example, you have a three month window.

>> I January, February, March beginning of the year to see if you like the plan if you do not like it, you have a one time opportunity to change either back to a at another advantage plan or you can go to original Medicare, pick up a drug plan, apply for a Medicare supplement.

You have that opportunity as far as a drug plan.

You do not have that opportunity once you select a plan during the app that's your plan for the next year.

>> You do not have a chance to reverse it.

Wow.

What are time schedules for that?

Well, you have the annual enrollment period is October 15th to December to December 7th.

>> OK, that's your time.

OK, so it started already.

Yeah you should begin to listen to what Greg saying and and read up and call your insurance company or get online whatever you need to do to make sure that you're a smart consumer.

>> OK, we were talking about the two thousand dollars and because of some drugs that are very popular now are very costly 500 or 600 dollars whatever a month you would meet that six or that two thousand dollars in just a couple of months and then the rest of the year you don't pay for correct.

>> The insurance company picks up the drug costs correct.

>> And keep in mind they've also instituted a new Medicare prescription savings plan where you can spread the cost of your drugs out over twelve months payment plans, payment plan.

>> OK, so for example, if you have the deductible for this year is five hundred and ninety dollars if you don't have five hundred and ninety dollars so that's going to be hard for you .

You can apply to the insurance company and sign up for a plan where they would spread that payment over twelve months.

>> I know what they call that the MPP and and three P O and three M three P OK the payment plan Medicare prescription payment plan.

>> All right so that is optional.

>> Yes that's optional.

That's optional.

So you don't we aren't looking at a case where all of you out there have to have this monthly payment plan but right.

You can apply for that.

>> What are parameters what do they base that on?

There's no problem.

I mean you can you can apply for it.

It doesn't make any sense if you if you don't hear your drugs aren't that expensive to apply for .

>> Right.

But yeah, if you're if you have more expensive drugs yes.

It can make a lot of sense to do it.

>> OK, from what I see it could be again maybe a very quick time that you're going to come to that two thousand dollar limit but then you can do the M three and the monthly payment plan and spread it out over twelve months and that's going to vary or will it be the same for everybody?

>> No it varies and it depends on what time you have your you started because it doesn't have to be in January.

>> Let's say you're prescribed the drug in May.

Yeah you can start that in May and they would just spread it out for the rest of the calendar year.

>> OK, but you have to apply for that on June or you apply to your insurance agent.

>> You you apply to the insurance company.

Your agent should be able to get you the application to do that.

>> OK, all right.

Good idea or defense so depends on what depends on the cost the drugs depends on your situation.

>> OK, all right.

A lot of depends a lot on why you have to listen closely because a lot of situations here with Medicare and and some of the upcoming changes that would be different for different people.

>> Most of you probably if you're a Medicare probably already gotten your supplement book.

It's called Medicare and you twenty twenty five if you haven't gotten it yet it should be coming any time I think I just got mine a few days ago last week maybe and again this is a very healthy blog we'll put it that way it's more a book lot but it has the answers to so many questions and there of course is an index so you can quickly go to the index the content table of contents and get an idea of the page numbers for what you want to know about for example, you know, you can get definitions of health things you can compare health and drug plans here what are the parts of Medicare so can give you some knowledge about what Medicare is finding the right coverage for you.

The original Medicare Medicare Advantage plans and other options so so many things what are probably the most common things people well a lot of times for well a lot of times there's a place in there for you can look at it current plans going on.

And speaking of that, some of you may notice if you go into that your plans are no longer there.

>> Yeah, this is a big topic.

Yeah.

I'm going to hold this up just so you get an idea of what it looks like in the plan comparison.

It'll list the different insurance policies and then what just just a brief overview.

>> Yeah.

What's our cover over what's there?

>> But what I was mentioning there was some plans that are no longer going to be available for twenty twenty five that were available this year.

>> Why yeah well insurance companies are in the business of making money so we have to mix it up and change things.

>> So if a company is not making money with plan or they're not making money in a particular area county, OK, they are pulling those plans and they might offer a substitution.

They they are they'll either offer a substitute or they might exit the plan or the county entirely.

So these are things that really can change what you're doing and it will make you have change plans whether you like it or not, whether you like it or not.

>> Greg, I really appreciate it.

You sent over a letter that is an example of what people might get in the mail.

-So we'll take.

And again, this is just a sample of what the letter might look like, what kind of information will be sent here.

>> Basically what it says in this particular one happens to be from Aetna.

It just says that that your plan is not going to be offered in twenty twenty five.

>> What this plan does if you'll notice it gives you an opportunity to go to a Medicare supplement without having to answer health questions.

>> OK, so this is like this is your golden ticket if you've ever wanted to go to a supplement you were an advantage plan and you had some health issues and you thought man, it would be nice to go to a supplement but you couldn't pass underwriting because of your health issues.

>> This is your ticket to do that because there's no health questions asked.

You can pick up a supplement without any problems at all that's advertised a lot I think in commercials about you know, no history, health history requirements and that sort of thing.

>> Well, that's the thing with with advantage plans supplements you only have that opportunity once you come off get into it for the first time .

>> I see that's it.

And if you switch supplement plans in the future you're going to have to answer health questions.

>> So this particular letter gives you that opportunity just to get a plan.

>> No questions asked.

I got that we have a call from Jim just came in as well.

And Jim, thank you by the way for watching LIFE Ahead here on PBS .

Let me tell you what GM wants to know.

Great.

He is enrolled with Blue Cross Blue Shield, Blue Cross Blue Shield and oh are you with us here Jim tonight?

>> Yes, ma'am.

Good.

I'm so glad when people talk to us on the air.

What is your question?

It's about Blue Cross Blue Shield, Jim.

Well, basically I'm in the federal employee program, OK?

And I have Blue Cross Blue Shield and I'm just joining Medicare and I'm still working at 65.

But I'm just curious if there'sh programs go with.

I have Medicare pay and I'm just curious with part B if I go with the original or one of the advantage plans if there's an easy answer for that ,is there an easy answer >> You're at the confusing age 65.

You're still working but think about thinking about not working starting Medicare there just a lot of things new things that you have to know.

>> So Jim, first off and this is a big misconception there's nothing that you have to do right now if you're employed and you have insurance through your employer, you don't have to sign up for Medicare.

didn't even need to have to do that unless you're you're employed by a group plan that has fewer than than twenty employees.

Other than that you don't have to sign up.

>> You may not get company that has to run a small business that has fewer than 20 employees.

You do have to sign up.

OK, OK.

But if it's larger you don't have to sign up at all now which would be the better way to go.

>> What's it going to cost you ?

What's the plan like if you're satisfied with your plan right now and you like it you can stay with it if you if you compare it to a Medicare supplement or Medicare Advantage plan and you feel that that would be a good fit given your health and what the cost is, you can enroll you're kind of at that point where you can do whatever you want.

Just know that you have some flexibility here.

Now the only limitation is if you leave a group health plan, some of them don't let you come back in some of them do.

>> So that's that's the only real thing that you have to worry about initially.

But as far as supplements and advantage plans, you can pick one or the other and you in the first year you can move to to the other if you like.

>> OK, I hope that helps you out GM And again some good advice from Greg.

Make sure that you get all the information that you can and don't hesitate to call us back again here the rest of this half hour if you have more questions.

Margarets on the phone as well tonight.

Margaret, thank you for watching.

LIFE Ahead tonight and meeting Greg MacDonald.

>> What is your insurance question, Margaret?

I had been grandfathered into the Asplin for many years and would have like to do would like to know is whether or not that plan has been changed.

I know that no there's been no change in plan if that will always be available to you people who turn sixty five twenty twenty forward cannot enroll enough plan people who were who had Heff available to them prior to twenty twenty they can remain in that plan.p>a plan if if they choose indefinitely.

>> Yeah there's no limitation on it.

So Margaret your plan is fine.

That's not going to be that going to change at all.

>> Oh I am sure that's very comforting for you Margaret.

Thank you again for giving us a call tonight again get on the phone (969) 27 twenty we'll be here the rest of this half hour to handle insurance questions.

OK, Greg, we talked about the annual notice of change and oh see you guys have so many abbreviations here.

Yeah.

So and that's all like the letter that we showed what other plans might be changing so that annual notice of change this is a reminder is in September companies have to send out a notice as to what the plans are changing, whether they're dropping them or not.

>> Well, yeah, whether they're whether and what what's going to be different for twenty twenty five that wasn't twenty twenty four.

OK, so those things will come out.

You ask about other changes I said you know we have some plans dropsonde with Humana another one to be aware of is IU Health has an advantage plan that's been available in the last few years and it's been very popular.

>> It's been a popular plan and it's really a nice plan.

>> But the problem is that except the hospital systems here in Allen County aren't real happy that I use building a hospital out on lower Huntington Road so they are not going to consider IU health in network .

>> So if you have that plan understand you can still see you doctors but if you go to doctors in Parkview Lutheran Network they're going to consider you out of network.

I say OK, switch could be an issue going forward.

Another thing there's a new plan coming out.

>> It's called Devoted Health Devoted his devoted health .

OK, it's going to be available in the counties around Allen County but it's not going to be available in Allen County.

>> OK, all right.

>> Those are some significant changes with the I health thing though.

I mean they're getting so many facilities all around town so it may not be too big of a problem.

>> I mean you can still see are you doctors?

Sure.

Just and you can go to a local hospital just understand it's going to be out of network and out of network.

Co-pays are higher than in our co-pays.

>> Right.

And sometimes they'll divide that demand that payment up front.

OK, it seems like mostly they do now occasionally there's some billing there but usually it's like what's your name?

What's your Social Security number?

Write me a check or give me your credit card.

Yeah, things like that.

Laura has just called in with a question.

She said Is there a payment plan with several thousand dollars and someone passes away in March?

Is it forgiven what happens with that plan?

Does that make sense to you?

>> I'm Laura.

I'm going to I'm not sure if there's a payment plan that's a Medicare plan right now that that would have happened but let's say it happens going forward and it's that to my knowledge there's not any collection mechanism to be able to make someone collect that, you know, from a dependent.

>> So no, I don't think that that would be an issue.

OK, all right.

Thank you for that.

OK, thank you Laura for watching us here tonight.

If you had to counsel and that's what you do every day is counsel people about insurance what are let's say let's talk about three things that are the most important things that these people out here watching tonight need to know, Greg, about changes that are coming for twenty twenty five.

>> Well, just know that you should need to review your your plans just to make sure that they're up to date and that's reviewing if you're an advantage plan not only reviewing the prescriptions but reviewing your providers, making sure that their network the other thing I want to mention is be wary of someone calling you on the phone and asking if scams yeah.

>> If you have the right plan and they want to see if you're missing out on benefits if you have not given that person permission to call you, they're doing it illegally and if you give that person your information and they enroll you in a plan, sometimes people get enrolled and they don't even know they're being enrolled.

>> OK, how could that be?

Because you've given them too much information.

They're just they're just asking questions and we can find you in a plan.

>> We can get you more benefits yada yada yada.

>> Just know that if you do that you're going to be moved to a plan that may not you may not want and you certainly will lose the agent that you're working with and then no longer be able to help you with that company.

So just be aware that don't talk to anybody who just calls you up on the phone.

In fact, be aware if you go online and you put your information and you're going to get calls.

>> So just be be aware that there's so much to be aware of nowadays.

And again, when you give out your own private information that makes you vulnerable to this, it does scam phone calls.

Norma, thank you for watching us here tonight.

>> What is your question about Medicare Advantage, Norma?

Yes, I have two one for my husband's plan on and Aetna premier plus plan I believe and he had got notification that he's not going there's not going to be available.

>> I didn't know if that was just not going to be available period or that's been a change and that's what we were talking about is in this letter of noticeable change.

>> Right.

So he is going to have to make another selection, OK, because if he does nothing they will not enroll him in anything.

So he's he is going to have to make a change before the end of the year to get coverage in that plan not available at all anymore.

>> No, they took it off the market altogether.

And then my other question is for my United Health Care plan they're changing the vision benefit to having a pair of glasses or contacts every two years.

Is that something that a lot of plans are doing or is that pjust United Health Care?

>> Everybody does it a little differently.

>> Every other year is not unusual but are there plans that allow it every year?

Yes, And again, I guess it's a case of you know, from what Greg has shared with me before of what's right for you.

>> I mean if this is important to you or dental or hearing, you'll need to make sure that your plans are accommodating you if it's not a big deal, you don't spend a lot of money on that then right?

>> Not a concern.

Very quickly, let's get a question here from from Robert.

He has United Health care plan policy.

Should he get an advantage plan or is it too late?

>> He's 80 years old as well as whether you should get an advantage plan.

I don't know.

There's other factors to consider.

Is it too late?

The answer is no.

It's never too late to switch to an advantage plan age is not a factor, OK?

>> And health is not a factor for an advantage plan because they don't ask health questions .

OK, all right.

That's good.

Anything else, Greg, that people need to know that before you leave us tonight I mean until we get to twenty twenty six with a lot of other changes we need to understand here just keep in mind there's a lot of information and confusion out there if you have questions and you have an agent call them and there's a lot of good agents out there.

>> Yeah.

So get in touch with your agent, ask questions and get some help because I'll tell you what it is confusing and an agent can make life a lot easier for you is that I recall there's not cost to talk to an agent to get advice you shouldn't if somebody charges you for do it walk away.

>> Call somebody else.

Yeah, call somebody else.

This is the book again that will be coming to you if it isn't there already Medicare in you twenty twenty five.

A lot of your question questions can be answered there.

Well we really appreciate all of you watching us here these last two weeks with Greg MacDonald giving us we needed an hour tonight.

We did.

We did.

I think we would have had a phone calls even meanwhile thank you all for watching.

Stay safe and stay healthy.

We're going to see you right here next Wednesday night at seven thirty tonight